Splint



. April 2, 1946;

J. C. BUTLER sPLm'r Filed Jan. 21. 1943 2 Sheets-Sheet l V April 2,1946. J. c. BUTLER 2,397,648

- SPLINT' Filed Jan. 21, 1943 2. Sheets-Shet 2 QJacoZ [7877? Beaver"Patented Apr. 2, 1946 UNITED STATES PATENT OFFICE 2,s97,c4s SPLINT JacobClem Butler, Milford, Del. Application January 21, 1943, Serial No.473,122

' (c1. 12s s7) 11 Claims.

The present invention relates to splints, and more particularly to atwo-piece external splint for use in the treatment of a broken,dislocated, or fractured mandible.

The principal object of the invention is to provide a practical splintadapted for universal use in the treatment of mandibular injuries andwhich splint is capable of use for such treatment irrespective of thesize and/or shape of the mandible and which can be adjusted to applyvarious ypes of stress, as required.

Another object of the invention is to provide an external mandibularsplint that can be used in combination with interdental typ s ofsplints, particularly where it is desired to maintain immobility of themandible.

Another object of the invention is to provide an external mandibularsplint adapted for use in either edentulous or dentulous types offractures.

Still another object of the invention is to provide an externalmandibular splint that may be quickly applied and adjusted for eitheremergency use until the patient is hospitalized, or for permanent use.

Still another object of the invention is to provide a mandibular splintthat may be easily and quickly removed, if necessary, even by thepatient himself in case of nausea, thereby avoiding possiblestrangulation.

A further object of the invention is to provide an adjustableexternalmandibular splint contoured to fit the curve of the lower jawand thus support the mandible during the bone-knitting st ge.

Still a further object of the invention is to provide a mandibularsplint which will permit X- rays to be taken of the mandible while thesplint is held in placel A still further object of the invention is toprovide a mandibular splint made of plastic, hard rubber, etc., that maybe readily cut orfiled away to permit access for surface treatment,particularly in case where the fracture of the mandible is due to agunshot wound or shell fragment.

A still further object of the invention is to provide an externalmandibular splint that may be attached to the head by means of straps orbuckles, or by means of ordinary bandage.

Other and further objects of the invention will be apparent from thefollowing description, taken in conjunction with the accompanyingdrawings, in which:

Figure 1 illustrates the two section mandibular splint of the presentinvention held in place on a patients face by attaching means comprisingsuitable straps and buckles cooperating ing the splint and attachingmeans as they appear in a full-face view;

Figure 3 is an enlarged sectional viewthrough one of the splintsections, taken on the line 3-3 of Figure 1, and particularlyillustrating one manner in which the loops or fastening members may beembedded in the splint material; I

. Figure 4 is an enlarged sectional view through one of the splintsections, taken on the line 4-4 of Figure 1; q

Figure 5 is a view of the splint sections as viewed from the sidethereof which engages thechin and lower jaw; and v v Figurefiillustrates the manner in which the splint sections may be attachedbyordinary bandage material to apply protrusive stress. w

Referring now to the drawings, the splint is generally indicated by thenumeral I, and comprises two sections 2 and 2a which normally areidentical in shape and configuration, except that one is generallycontoured to fit the right side of the chin and jaw and the other iscontoured to fit the left side. As will be apparent from Figures 1 and2, each of the splint sections 2 and 2a includes a chin-engaging portion3 at its forward end adapted to be positioned in engagement with thefrontal portion of the chin, and a temple portion 4 at its rear end andincluding a part; 4a extending upwardly to a point adjacent the ears(not shown). Each of the splint sections also includes a lower inwardlycurved portion 5 extendw ing rearwardly from the chin-engaging portion 3toward the temple portion 4 and. adapted engage the underside of thejaw. H I

The distance between the chin-engaging portions 3 of the splint sections2 and Z'a is adapted to be varied to suit the width of the chin andlower jaw angle of various patients. Thus, a fastening member 6 ispreferably embedded in each of the splint sections 2 and 2a at a point ashort distance inwardly from the edge of the chin-en gaging portions 3,the fastening members being substantially staple-shaped and providingexternal loops adapted to be used in connecting the sections 2 and 2atogether. A second fastening member 1 is mounted in each of the sections2 and 2a in the curved portion 5 intermediate the ends of said sections,the fastening members 1 being arranged to provide loops at an angle tothe fastening members 6. I I

In applying the splint to a patient, the splint sections 2 and 2a can bereadily positionedinwith said tape, taking up or providing slack, andthen fastening said end in place again. In order toadjust the splintsections'2 and 2a; for the proper angle in the distal area ofthemandible, a second strip of adhesive tape 9 is passed through thefastening loops 1 and its ends then overlapped below the chin of thepatient to adjust or secure the sections 2 and 2a in properangularrelation.

It will be clear from the foregoing that the invention provides apractical splintcapable of substantially universal use in thatbysuitable adjustment of the tape 8, the splint sectionsz and M can bespaced to suit any width of 'chin and by suitable adjustment of the tape9,v said splint'sect'ions can be connected together on any angle toaccommodate the angularity of the mandible in the distal area.

The fastening members I, as has been previously noted, are positioned atan angle, so that when the splint is in use the adhesive tape 9 securedto said fastening members is positioned,

so that it has no tendencyto choke or constrict thebreathing of thepatient. Any further adjustment of the tape 9- to change the angle ofadjustment of the sections l and 2 can be made inthe same mannerdescribed in connectionwith the tape 8'.

The temple portions 4a of the sections 2 and 2acarry fastening loops ormembers H], H and I2 which, for convenience, are arranged in steppedrelation, as best illustrated in Figure 1; The loops f, H and I 2 arealso horizontally orlaterally spaced relative to eachother to permitthea'ppli'cation of retrusive, vertical, and protrusivestress;respectively, as will be pointed out more fully hereinafter. The mannerof embedding the fastening members H), H and l2fi'n the splint sections2 and 2a is best' shown in Figure 3, wherefrom it" will benoted that theextremities of said fastening members carry an enlargement [3* which,upon being embedded, prevents said fastening membersfrom being pulledout of the splint sections. It will be understood that thefastening-members 6 and Tare preferably similarly" secured in the splintsections 2 and 2a.

It will be noted that, while the fastening members l-D H and I2 are"arranged at different ver-' ti'cal heights relative to the respectivetemple portions 4a, they are also spaced horizontally enabling each tobe used independently as a means for attaching the splintas a whole tothe head. Figure 1 illustrates the manner in which the splint may beapplied when it is desired to exert a vertical stress upon the mandible.In such instance, the middle fastening members [I have; the headgearattaching means secured I thereto. A convenient-means for attaching thesplint ishere illustrated as comprising a strap- M'; which extendstransversely of the head, and through the loops II, the free ends l5 ofsaid straps passing through suitable buckles i6, whereby asuitablestress can be applied to the mandi ble: by adjusting the strap ends l'5upon the opposite sides of the head. The strap I4 is fastened by a rivetI! or other suitable means to a second strap l8 which extends around thehead and is provided with a suitable buckle i9, prefer thereof extendthrough the: loops H3 or l2,

so: that stressi may be applied to the: mandible through the splint tomeet other conditions. For

. example, by passing the ends l5 through the trusivedislocation ordisplacement.

loops IU of each of the splint sections, a retrusive stress may beapplied in the case of a prothe strap ends I 5 may be passed through theloops E2 to apply protrusive stress to overcome the natural displacingtendencies of the throat and any muscles thereof which may have becomespastic due to injury.

' It will be apparent from the foregoing; that. the present splint, byvirtue of its two-piece construction, is adapted for universal useandenables the necessary and proper stress tov be applied for breaks,fractures or dislocations of cated at 20, to expose said ailment.

manner, it possible to render the necessary the mandible. The use ofadhesive strips 8 and 9 for chin and angular adjustment not onlyprovides a sort of flexible hinge for the splint sections 2 and 2a,but'also' enables the splint sections to be adjusted with a minutenessof accuracy that could. not be attained with leather straps or similarstrap fastening means. Once the strips ofadhesive tape have beenproperly adjusted, there is no danger of slippage and the" adjustment,therefore, remains permanent for the individual.

Figure 1 further illustrates" the adaptability of the present splint foruse in treating. patients having. jaw wounds', cuts or infections thatnormally would be difficult to" treat. without disturbing the adjustmentof the splint; Thus, in

the case of a surface? ailment. requiring treat ment in the region ofthe mandible; a portion ofthe' spiin'tsection 2 can be removed, aszindi-In this surface treatment without removing or changing the adjustment ofthe splint. i

The"- splint comprising the present" invention maybe made of anysuitable material, such as light metal or hard rubber, but'is preferablymade of transparent plastic material, with the exception of the loopelements 6, 1, I0, I i and [2 which,

for convenience, are preferably made of metal and embedded in theplastic. When the splint sections are made of non-metallicmaterial theyafford the advantage of permitting X-rays to be taken. However, it is tobeunderstood that the present invention is not to be limited orrestricted to fabrication by any particular materialor combination' ofmaterials, nor'to the particular manner' in which the loop elements aresecured to the splint sections; 7

Figure 6 further illustrates" the adaptability of the invention foreither emergency or perma-- nentuse, in that it shows one manner ofsecur ing the splint to the head by use of ordinary bandage? As ishereshown, a stay banda e 25 is wrapped around the head. and its freeend secured by adhesive or any other means (not shown). A second stripof bandage 26 is threaded under the loops or fastening members. I2 toapply a protrusive stress to'the: mandible. The: I free'endsofthe'I'strip-of' bandage zs ar'e -tid-to:

Similarly,

gether at the top of the head, and a strip of adhesive 21 is appliedacross the strip of bandage 26 adjacent the temples to prevent itsdisplacement relative to the stay bandage 25. In this manner, themandibular splint may be applied and attached to a patient without usingthe headgear-comprising the straps and buckles shown in Figures 1 and 2.

Fig. 6 still further illustrates the adaptability of the present splintfor use in applying stabilizing tension in cases of extreme displacementof the mandible due to spasm, frequently resulting from delay intreatment. In this connection, each of the splint sections 2 and 2a isprovided with an additional loop or fastening member 33 positioned belowand forwardly of the loop H! at a point about midway of the length ofthe splint sections. As will be noted, the loop 33 is so arranged that arubber band 34 may be passed therethrough and its ends 35 secured by asafety pin 36 to the bandage 25. The rubber band 34 will apply theauxiliary, constant upward tension necessary to maintain the mandible inplace until the spasms subside.

Obviously, the loop 33 and a rubber band or any other-suitable tensionmeans may also be used to apply a stabilizing tension in the treatmentof maxiallary fractures when greater or supplemental pressure isrequired in the anterior region. The'loop 33 is also adapted to be usedto provide auxiliary pressure when a constant occluding pressure isessential to hold the fragments of the mandible in their correct normalanatomical position.

It will be manifest that the splint of the present inventionisadapted'for use in the treatment of edentulous or dentulous mandiblecases, and also readily usable with interdental types of splints withoutconflict. It will be further manifest that the feature of variouslypositioned fastening members'to apply retrusive, vertical orprotrusivestress as well as auxiliary stabilizing stress is not limitedto a two-piece splint but may also be advantageously used in certainonepiece splints.

' While the splint comprising the invention has been illustrated anddescribed as having a certain shape and configuration, and the fasteningmeans have been described as mounted in certain portions of the splintsections, it will be understood that variations may be made in theconstruction of the splint sections and in the character and arrangementof the fastening members without departing from the spirit or scope ofthe invention.

What I claim is:

1. An external mandibular splint, comprising: left and right sections ofcomplemental shape generally contoured to fit the lower jaw, each ofsaid sections including a chin-engaging portion at the forward endthereof and a temple portion at the rear end thereof; means operativelyconnecting said splint sections together; and a series of spacedfastening members carried by each of said temple portions, saidfastening members being arranged to cooperate with suitable strap orband means for securing the splint sections in place, one of saidfastening members being positioned in said temple portion forapplication of retrusive stress, another for vertical stress, andanother for protrusive stress.

2. An external mandibular splint, comprising: left and right sections ofcomplemental shape generally contoured to fit the lower jaw, each ofsaid sections including a chin-engaging portion at the forward endthereof and a temple portion at the rear end thereof; flexible meansconnecting said chin-engaging portions together; three horizontallyspaced temple loop members carried by each of said temple portions; andattaching means adapted to be connected with corresponding loop memberson said splint sections for securing the splint sections in place, oneof said temple loops being positioned and cooperable with said attachingmeans for application of retrusive stress, another for vertical stress,and another for protrusive stress.

3. An external mandibular splint, comprising: left and right transparentplastic sections of complemental shape generally contoured to fit thelower jaw, each of said sections including a chin-engaging portion atthe forward end thereof and 'a temple portion at the rear end thereof;and a metallic loop member embedded in each of said chin-engagingportions, said loop members being arranged to be flexibly connectedtogether with said chin-engaging portions spaced apart a distancedepending upon the width of the chin.

4. An external mandibular splint, comprising: left and right sections ofcomplemental shape generally contoured to fit the lower jaw, each ofsuch sections including a chin-engaging portion at the forward endthereof and a temple portion at the rear end thereof, each of saidsections having a lower inwardly curved portion extending rearwardlyfrom said chin-engaging portion toward said temple portion and adaptedto engage the underside of the ja a loop member carried by each of saidchin-engaging portions, said loop members being arranged to be flexiblyinterconnected with said chin-engaging portions spaced apart a distancedepending upon the width of the chin; and a loop member carried by eachof said inwardly curved portions at a point intermediate the ends ofsaid sections, said last-mentioned loops being adapted to be flexiblyinterconnected with said sections angularly disposed in accordance withthe width of the lower jaw in the distal area.

5. An external mandibular splint, comprising: left and right sections ofcomplemental shape generall contoured to fit the lower jaw, each of suchsections including a chin-engaging portion at the forward end thereofand a temple portion at the rear end thereof, each of said sectionshaving a lower inwardly curved portion extending rearwardly from saidchin-engaging portion toward said temple portion and adapted to engagethe underside of the jaw; a loop member carried-by each of saidchin-engaging portions, said loop members being arranged to be flexiblyinterconnected with said chin-engaging portions spaced apart a distancedepending upon the width of the chin; a loop member carried by each ofsaid inwardly curved portions at a point intermediate the ends of saidsections, said last-mentioned loop members being adapted to be flexiblyinterconnected with said sections angularly disposed in accordance withthe width of the lower jaw in the distal area; and at least one loopmember carried by each of said temple portions arranged to cooperatewith suitable headgear means for securing the splint sections in place.

6. An external mandibular splint, comprising: left and right sections ofcomplemental shape generally contoured to fit the lower jaw, each ofsaid sections including a chin-engaging portion: at the forward end.thereot and a; temple portion at therear end thereof, eachofsaidsections also having a-l'ower inwardly curved portion extend ingrearwardly from said chin-engaging. portion toward said temple portionand adapted to engage the under side of the jaw; flexible means in frontof said chin-engaging portions interconnecting said chin-engagingportions, with said chin-engaging. portions spaced apart a distancedepending upon the width of the chin; flexible meansb'elow said inwardlycurved portions interconnecting said inwardly curved portions at a pointintermediate the ends of said sections with said sections angularlyarranged in accordance with thewi'dth of the lower jaw in the" distalarea; and head gear nieans'interconnecting said temple portions arrangedto serve as an attaching means for securing the splint sectionsin place.

7. An external mandibular splint, comprising: left and right sections ofcomplemental shape generally contoured tofit the lower jaw, each of saidsections including a chin-engaging portion atthe forward end thereof anda temple portion at the rear end. thereof, each of said sections alsohaving a lower inwardly curved portion extending rearwardly from saidchin-engaging portion toward said temple portion and adapted to engagethe under side of the jaw; a fasteningmember carried by each of saidchin-engaging portions arranged to be interconnected with saidchinengaging, portions spaced apart a distance depending upon the widthof the chin; afasteningmember carried by each of said-inwardly curvedportions at a point intermediate the ends of said sections and beingarranged. to be interconnected at: the rear end thereof,- each or saidsections also having a lower inward-1y curved portion: extendingrearwardly from said chin' enga-ging ortion toward said temple portionand adapted to engage the'under side of the jaw; a lo'opmemb'er carried:by each of. said chin -engaging portions; adjustable meansinterconnecting said loopmembers with said chin-engaging portionsspacedapart a distance depending upon the width of the chin, a second:loop member carried by each oi said inwardly curved portions at apointintermediate the ends of said sections adjustable means inter connectingsaid second=mentioned loop": members to an'gularly space said. sectionsin accordance with the width of the lower jaw the distal area; and aseries of laterally spaced temple l'oop members carriedby each of saidtemple'portions, said temple 1001) members being arranged to on operatewith suitable fastening means for secur 'ing the splint sections in'place, one of said templel'oop's being positioned insaid temple portionfor application of retrusive stress, another for var: tical stress, andanother for protrusive stress.

10. An external mandibular splint,v comprising:

left and right sections of complemental' shape generally contouredto'fit the lower jaw, each of said sections including a chin=engagingportion at the forward end thereof and a temple portion: at the rear endthereof, each of said sections-also having a lower'inwardly curvedportion extending rearwardly from said chin-engaging portiontotoangularly space said sections in accordance with the width of thelower jaw in the distal area; and at least one fastening. member cariredby eachof said temple portions arranged to cooperate with suitable headgear means for securing the splint sections inplace.

8. Anexternal mandibular splint, comprising: left and right sections ofcomplemental shape generally contoured to fit the lower jaw, each ofsaid sections including a chin-engaging. portion at the forward endthereof and a'temple portion a the rear end thereof, each of saidsections also having a lower inwardly curved portion extends ingrearwardly from said chin-engaging portion towardysaid temple portionand adapted to engage the under side of the jaw; a loop member carriedby each of said chin-engaging portions, .djustable means interconnectingsaid loop meme bers with said chin-engaging portions spaced apart adistance depending upon the width of the chin;- a second loop membercarried by each of said inwardly curved portions at a point intermediatethe ends of said sections; and adjustable means interconnecting saidsecond lo'opfmembers to angularly' space" said sections.

' 9. external mandibular splint, comprising: left and right sections ofcomplemental' shape enerally contoured to fit the lower jaw, each ofsaid sections including a chin-engaging portion at the forward endthereof and a temple portion ward said temple" portion. and adapted. toengagethe underside of thejavv; al'oopmember carried by each of saidchin-engaging portions;i'adjust able means interconnecting? said loopmembers with said chin-engaging portions spaced apart a distancedepending upon the width of the a second loop member carried by each ofsaid inwardly curved portion's at a point intermediate the" ends of saidsections; adjustable m'e'ans inter connecting said second-mentioned loopmembers" to angularly space said sections in accordance with the'wid'th:of the lower jaw in the distal area; a seriesofi laterally spacedtempl'eloop members carried by each of said temple portions; and head gearmeans adaptedto be connected with corresponding loop members on saidsplint sections for securing? the splint sections in place, one or: saidtemple loops being-positioned for applica tion of retrusive-stress,another for vertical stress,- and another for I protrusive stress l 'l.Ari-external mandibular splint, comprising: a plurality of splintmembers, eachof saidsplint members being generally contoured to fit the"lower jaw and including a chin engaging portion and a temple portion;and a plurality of fastening means carried by said temple portion saidfastening means being arranged to be connected with suitable headgearmeans for securing said splint member in place, saidfastening meansbeing selectively connectible with'said headgear means and cooperablewith: said headgear means for applying either a ret'rusive stress, avertical stress, or a protrusive stress;

